What causes bones to crack?

From the Guidelines

Bones crack due to a variety of factors, including osteoporosis, stress fractures, and the release of gas bubbles from joint fluid, with the most significant risk factor being a prolonged decrease in bone mineral density (BMD) and quality, as noted in the study by 1. The cracking of bones, also known as fractures, can occur due to various reasons, including:

• Osteoporosis, a systemic skeletal disease characterized by low bone mineral density (BMD) and poor bone quality, leading to reduced bone strength and increased risk of fracture, as stated in the study by 1.
• Stress fractures, which occur in two varieties: fatigue fractures resulting from repetitive submaximal stress on normal bone, and insufficiency fractures due to normal activity on bones that are deficient in microstructure and/or mineralization, as explained in the study by 1.
• The release of gas bubbles from joint fluid when the joint is manipulated or moved suddenly, a process called cavitation, as mentioned in the example answer. The most common areas where bones crack include the distal radius, proximal humerus, hip, and vertebral body, as noted in the study by 1. It is essential to evaluate non-DXA osteoporosis tests that are sensitive, inexpensive, and easily implemented, as stated in the study by 1, to diagnose and prevent osteoporotic fractures, which constitute a major public health concern, with 1 in 2 women and 1 in 5 men having a fragility fracture in their remaining lifetime after the age of 50 years, as reported in the study by 1. Key risk factors for osteoporosis include age, low body weight, weight loss, physical inactivity, use of oral corticosteroids, and previous fragility fracture, as identified in the study by 1. The economic burden of managing fragility fractures worldwide is estimated to be in excess of $100 billion USD, with indirect costs close to $200 billion, as stated in the study by 1. Therefore, it is crucial to prioritize the evaluation and treatment of osteoporosis to reduce the risk of fractures and improve the quality of life for individuals at high risk, as emphasized in the study by 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Causes of Bone Cracking

• Daily loading activities can cause cracks to form and grow in bone through the mechanism of fatigue 2
• Bone loss and impaired bone strength, characteristics of osteoporosis, can increase the risk of fractures and bone cracking 3, 4
• Cyclic stresses can contribute to the growth of small cracks in bone, which can be detected and removed before they become dangerous 2

Factors Influencing Bone Health

• Bisphosphonates, a type of medication, can reduce the risk of fracture by suppressing bone resorption and increasing bone strength 5, 3, 4
• Vitamin D-hormone analogs, such as calcitriol and alfacalcidol, can be used in combination with bisphosphonates to improve bone health and reduce the risk of fractures 6
• The use of bisphosphonates and other medications for osteoporosis requires careful consideration of benefits and risks, as well as monitoring and duration of treatment 3, 4

Bone Repair and Maintenance

• Bone has the ability to repair itself by detecting and removing small cracks before they become dangerous 2
• The repair process involves the cooperation of materials scientists, biologists, and engineers to understand how cracks form and grow in bone, and how they can be detected and repaired in a timely manner 2